Connections Program for High-Risk Infants and Families

• Develop health behavior assessment and intervention skills to promote infant health, development, and family engagement in the NICU.
• Collaborate and liaison with a multidisciplinary team.
• Build knowledge and skills in working with families of high-risk infants and provide psychoeducation and anticipatory guidance for needs that may present after NICU discharge.
• Develop and coordinate treatment plans for infants and their families as they prepare for discharge.

• Interns will learn CL skills for working in a NICU setting.
• Obtain competence in health behavior assessment and intervention approaches for infants born with medical complexities.
• Engage in consultation and liaison services with the medical team, including providing feedback about patient and family care approaches and trauma-informed care practices.

• Health behavior assessments and interventions with infants in the NICU.
• Participation in multidisciplinary rounds and meetings.
• Maternal mental health screening and response.
• Participation in quality improvement activities to improve family engagement in the NICU.

Supervisor theoretical approaches include cognitive-behavioral, interpersonal therapy, and infant mental health orientations.

• Maternal mental health screening and response.
• Health Behavior Assessments and Interventions including caregiver-infant dyadic interventions, communication training, problem-solving skills training, brief cognitive-behavioral interventions to promote parental coping.
• Participation in multidisciplinary team rounds.
• Quality and process improvement.
• Psychoeducation about infant social-emotional, behavioral, and cognitive development.
• Multidisciplinary collaboration.
• Consultation and Liaison.

The NICU provides Level III medical services to children born with neonatal complications and is the largest Level III NICU in Metro Denver. The unit cares for an average of 650 unduplicated patients per year. Approximately 25% of admitted infants are born at gestational ages less than 29 weeks and/or birth weight of less than 4 lbs, and about 20% are considered very low birthweight. The payer mix is around 40% Medicaid and 60% private insurance. Average length of stay is 14-17 days for the entire patient population. The Connections program delivers maternal mental health screening and response, health behavior interventions, and wellness promotion services to infants and families on the unit and during their transition home.

The Connections Program automatically sees infants born under 32 weeks gestation and older babies if specific concerns are identified that necessitate a consult to the service. On average, the team has a case load of approximately 20-25 infants per week divided among the various clinicians on the service.

At least one hour of weekly supervision is provided to the intern for initial assessments, brief intervention, and consultation-liaison services. Service delivery typically involves a preceptor model in which the clinician is present to observe a portion of the session and discuss case conceptualization and recommendations in real time. We adopt developmental and reflective supervision approaches and work to align the training experiences with the trainee’s professional goals and training background/experiences. Interns will have the opportunity to attend biweekly reflective supervision/peer consultation with the perinatal/infant mental health providers in the department of psychiatry. Interns begin by shadowing for orientation and then incrementally advance to a preceptor model.